NPI | 1497058879 |
---|---|
Former Name | BETHANIE M MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9263008) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2010-12-07 |
Last Update Date | 2022-02-28 |